The management of ectropion using the tarsoconjunctival composite graft

To demonstrate the technique, advantages, and results of autogenous tarsal grafts in the treatment of ectropion with lower eyelid retraction.

Fourteen patients treated with autogenous tarsal grafts were evaluated. Follow-up ranged from 6 to 30 months (mean follow-up, 10 months).

All patients were treated at the University of Kansas Medical Center, Kansas City, December 1990 through June 1993.

Of 14 patients with ectropion who were treated with this technique, nine had facial nerve paralysis, three had had previous periorbital trauma resulting in cicatricial ectropion, one patient had orbital and congenital lower lid fibrosis, and one patient had Graves' ophthalmopathy with lower lid retraction.

All patients underwent autogenous tarsal grafting. Eleven patients also underwent combined laterocanthal suspension (tarsal tongue technique). Seven patients underwent associated upper lid gold weight loading. One patient underwent a medial canthopexy.

All patients had marked improvement functionally and cosmetically. One patient had slight under-correction. Results have remained stable for over 2 years.

Autogenous tarsal grafts aid in the long-term stability of lower lid ectropion repair. Autogenous tarsal grafting has distinct advantages over other described techniques. When treating paralytic ectropion, other rehabilitative techniques must be additionally employed.